Treatment of Sexual Abuse

1. Understanding Child Abuse and Neglect
Tenth Edition
Chapter 14
Treatment of Sexual Abuse
PowerPoint Lecture
Slides prepared by
Piljoo Kang, Ph.D.
Toccoa Falls College
Copyright © 2021, 2014, 2010 Pearson Education, Inc. All Rights Reserved

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Learning Objectives (1 of 2)
After studying this chapter, you should be able to
14.1 discuss some of the crucial assumptions when
seeking to case manage or treat the sexually abusive
family.
14.2 describe the phases that a family goes through
during intervention and treatment.
14.3 explain some of the treatment needs of a sexually
abused child and how these might be addressed.

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Learning Objectives (2 of 2)
14.4 discuss the treatment needs of a non-abusive
parent, often the mother.
14.5 describe the treatment needs of sexual abuse
perpetrators both inside and outside the family, also
considering how this differs if the offender is a juvenile.
14.6 discuss how parents of children abused outside
the home might have their own individual needs.

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Assumptions About the Treatment of
the Sexually Abusive Family
• Relational imbalances were present before the incest
occurred
• Despite the dysfunction, the imbalances may have felt
comfortable to the family members
• Must find replacement for the dysfunction behavior,
which offenders rationalize as serving a purpose
• Do not assume the family will stay together or will
separate.
• It will be difficult for a family to talk about sexual issues.

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Treatment Models
Child Sexual Abuse Treatment Program
(Founded in 1970’s by Giarretto)
• Professional staff: social workers, probation officers,
attorneys & judges create treatment plan
• Lay volunteers: student interns who provide
transportation, one-to-one support, & office duties
• Self-help groups: Parents United, Daughters and Sons
United, give support and group therapy

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Issues Addressed in Family Treatment
• Realignment of generational boundaries and roles.
• Teaching the family members how to communicate
effectively to get their needs met.
– Adults: parenting skills
• Addressing parents’ unresolved traumas from their own
childhood

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Phases of Intervention: Disclosure-Panic
• State of acute crisis; family’s initial defenses include anger,
denial, and rationalization:
– family members may overreact, sometimes violently,
withdraw, blame others, or become suicidal
– victims often blame themselves
• Throughout this phase, the worker uses Trauma-informed
crisis intervention techniques & assure the victim that
he/she is believed by the worker and will be protected in
the future.

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Phases of Intervention: Assessment-
Awareness
• Family accepts reality of abuse
• Family develops dependence on worker
• Realign generational boundaries through marital
therapy; strengthen mother-child bond; return child to
child role
• It can be helpful if the perpetrator apologizes
• Fear fluctuates with hope
• Bursts of insight may lead to premature termination

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Phases of Intervention: Restructure
• Family adopts more functional patterns; maintain
appropriate boundaries
• May be reunited
• More open and honest communication; improved
coping mechanisms
• Both parents must take responsibility
• Victim has regained a sense of power
• All members have increased sense of self-worth and
ability to empathize

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Treatment of the Child and Adolescent
• Issues: trauma from abuse, family disruption following
disclosure, & exposure to the criminal justice system.
• Must overcome feelings about being damaged, guilt, fear,
depression, low self-esteem, repressed anger, role
confusion, and pseudomatury masking the failure to have
completed certain developmental tasks.
• Trauma-focused cognitive-behavioral therapy (TF-CBT):
treat both the mind and the body so that the victim could thrive
after trauma
– Education & age appropriate treatment modality
– Art therapy, journaling, story writing
– Group therapy is effective with adolescents.

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Treatment of the Non-Abusing
Parent (Mother)
The goal is to strengthen her to protect her child.
• resolve her conflicts over her own collusion in the abuse.
• improve her own self-concept
• learn to trust other, make her needs known,
communicate more effectively and become more
assertive to defend/protect her child.
• Group therapy seems to provide more opportunities for
support and growth.

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Treatment of the Perpetrator
• Treatment depends on the type (incestuous or
extrafamilial), residence (incarcerated), and gender.
• Goals are to help them to
– take responsibility for the abuse
– understand their abusive pattern & how to break
them
– develop better self-concepts
– not to relapse
• If incarcerated, may or may not receive treatment; without
treatment, rehabilitation does not occur.

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Treatment of Juvenile Offenders
• Some youth, who act out the trauma of their own abuse,
are often erroneously labeled as offenders.
• Need intensive treatment for a youth exhibiting severe
pathology, sexually molesting other children.
• Cognitive-behavioral therapy (CBT) which targets
– taking responsibility for the offence
– developing healthy relationship skills
– understanding the victim’s perspective.
• Untreated offender may reoffend.

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Preservation of Incestuous Families
• When protective services intervene in an incest
situation, the preferred intervention is often to
remove the offender in order to stabilize the family
and protect the child.
• Non-abusive parent has to believe the child and be
willing to protect him/her.
• Intensive family intervention may help, but each
member of the family must be highly motivated to
preserve the family.

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